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Survey about flu, work, acne, eyes, chocolate and earthquakes.

Begin Survey

1. Do you take a bagged lunch to work every day? Yes No

2. Do you run the vacuum (or sweep) your floors every day? Yes No

3. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

4. Do you own your own business or work for yourself? Yes No

5. Will you visit a beauty salon this week? Yes No

6. Have you ever taken dance lessons? Yes No

7. Do you know CPR? Yes No

8. Do you play any musical instruments? Yes No

9. Do you plan on visiting a mall this week? Yes No

10. Are you left-handed? Yes No

11. Do you get a flu shot every winter? Yes No

12. Did you vote in the last Presidential election? Yes No

13. Do you have or use a PDA (Personal Digital Assistant)? Yes No

14. Do you splash in mud puddles? Yes No

15. Do you follow a low-carb diet? Yes No

16. Would you like a free video or CD-ROM with more information on owning or renting an RV? Yes No

Your Firstname:

Your Emailaddress:

Yes, I would like to join the Daily Life Survey!

Fun and Interesting facts: - Oil tycoon John D. Rockefeller was the world's first billionaire. - Chocolate does not cause acne. - One in 500 humans has one blue eye and one brown eye. - The Sears Tower in Chicago has its own zip code.

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